Asbestos Inspector Faking Data in NYC

As the news of the New York City asbestos inspector continues to astonish and outrage most of us, the implications and the outstanding questions regarding such conduct, continue to puzzle investigators and citizens alike.  Saverio Todaro admitted to have not actually performed tests to backup the hundreds of reports that he has filed, in which he claimed no asbestos or led were present.  For over ten years, hundreds of construction sites and buildings were given a clean bill of health, when in reality, that may not have been the case.

Todaro’s guilty plea is not the end of the story, however. Investigators are now looking to find if report falsification is a common practice among inspectors in New York City, and they are investigating the regulatory systems which weren’t able to catch this dangerous practice.

Read the full New York Times article here and use the comments section to voice your opinion.

21st Century Snake Oil – 60 Minutes Special

Mesothelioma patients and their families are particularly vulnerable to ill-meaning “medicine salesmen”, such as the ones portrayed in this special investigation by 60 Minutes. Take a few minutes to watch these videos and please share if you have personally experienced something similar. The only way to stop these scams is to speak up.

21st Century Snake Oil – Part 1

21st Century Snake Oil – Part 2

Follow-Up to NY Times’ article on Palliative Care

In the Sunday Times dated April 11th there were some very thought provoking responses to the article we posted last week regarding palliative care.  I think this is an area of great interest to our patient population and I would like to continue the discussion.  I read with great interest the responses from palliative care experts and I am convinced that so many of you would benefit from requesting that palliative care become part of your expert medical team.  Fran Heller a much respected member of NY Presbyterian Hospital/Columbia University will be leading a group as well as meeting with patients and family members who would like expert advice.  There will be many professionals from various disciplines on hand so please take advantage of their expertise.

Letters to the Editor, New York Times, April 10

If you haven’t read our previous blog, take a look here and also make sure to go through the comments sections.

Empowering the Mesothelioma Community

As the time for the Symposium draws near we are all filled with a sense of excitement.  We strive to build upon the momentum gained in prior years and hope that we meet the expectations of both new and seasoned Symposium attendees.  This year we will have a new roundtable composed of patients and healthcare providers.  In this session I hope that we can identify the strengths that allow those with mesothelioma to continue to lead full and rewarding lives.  What does it take to get from the early days of diagnosis to becoming a whole and healthy person who also happens to carry the diagnosis of mesothelioma?  Knowing that you have an incurable disease, do you hope for the best and prepare for the worst?  Is that even possible?  I hope to explore these questions with patients. I also wish to open a dialogue about what it takes to be on the other end of the exam table, as a provider, charged with delivering the news, and then providing hope with reality.  It is a fine balance and the providers we have chosen to partake in this discussion are known for their compassion and honesty.  I hope that by exploring the patient and provider experience we can come away with better communication skills and a better understanding of what it takes to fill either set of shoes.

Physicians’ decision-making style and psychosocial outcomes among cancer survivors. Arora NK, Weaver KE, Clayman ML, Oakley-Girvan I, Potosky AL. Patient Educ Couns. 2009 Dec;77(3):404-12. Epub 2009 Nov 4.

Patient-centered communication and prognosis discussions with cancer patients. Shields CG, Coker CJ, Poulsen SS, Doyle JM, Fiscella K, Epstein RM, Griggs JJ. Patient Educ Couns. 2009 Dec;77(3):437-42. Epub 2009 Oct 9.

Measuring therapeutic alliance between oncologists and patients with advanced cancer: the Human Connection Scale. Mack JW, Block SD, Nilsson M, Wright A, Trice E, Friedlander R, Paulk E, Prigerson HG. Cancer. 2009 Jul 15;115(14):3302-11

Which patients improve: characteristics increasing sensitivity to a supportive patient-practitioner relationship. Conboy LA, Macklin E, Kelley J, Kokkotou E, Lembo A, Kaptchuk T. Soc Sci Med. 2010 Feb;70(3):479-84. Epub 2009 Nov 10

Bereavement: addressing challenges faced by advanced cancer patients, their caregivers, and their physicians. Kutner JS, Kilbourn KM. Prim Care. 2009 Dec;36(4):825-44. Review.

Palliative Care and Difficult Decisions to Stop Treatment

This Sunday I was struck by the New York Times article titled “Helping Patients Face Death, She Fought to Live,” about Dr. Desiree Pardi, a leading clinician in palliative care who herself became a cancer patient faced with deciding when to stop treatment and when to focus on palliative care instead.

As a practitioner and health care advocate, I have often found myself involved with patients who are at the crossroads of ending active treatment and focusing on comfort care. This article highlights well the personal nature of such a decision. As practitioners, we can provide information and support, but it is the patient who ultimately must choose which path to follow.

I believe that in a situation in which a patient and physician find themselves at odds regarding topics of continuation or end of treatment, a mediator should be consulted to help resolve these difficult issues.  In the best case scenario a medical ethicist or palliative care practitioner should be asked to help to ease the burden that both the patient and healthcare provider are struggling with.  In theory, paternalistic medicine is no longer practiced and as healthcare providers, we are tasked with providing the patient with the education to make informed decisions (choices).  This also implies that a patient is able to make those choices based on free will and a good understanding of the impact the choice will have on their lifespan.  I imagine that as healthcare reform continues to evolve, end of life decision-making will become part of a national debate.  I know that, as a medical provider, I will continue to learn from my patients and their loved ones.

Read the article by clicking here.